Am I the only one that’s in denial?

I was in denial, then my worst area, L-4 got to a -4.1. That scared me. I tried no drugs, and about 15 hours a week of exercise (heavy weightlifting and pickleball), and added protein to my diet and the supplements I already take. I improved that to a -3.3 in 13 months, but my femoral neck wasn't changing, so my Dr said I had to start something. I refused the Fosamax type drugs (thank goodness) and started Tymlos 11 months ago.

Three things I think you should consider to help make your decision. First, you do not have osteoporosis in just one area. You have it everywhere! So your hips might be bad, but so are your wrists, ankles, ribs, etc. Heaven forbid, you break a bone, many times surgery can't be done until your bone density improves, so then they will put you on the drug that you don't want to take, and because of your broken bone, you won't be able to exercise to get the full benefit of the drug, then you'll be on it longer, have worse results from the surgery, and it can be a vicious downward spiral...
Second, for every person who comments about a bad reaction here, I'd guess there are probably 90 women taking the drug with no side effects. So don't be so scared. Like others have said, you can titrate your dose and start out slowly on Tymlos and I think Forteo too, to lessen any side effects. I'm only on 5 clicks after 11 months, but still getting great results, and I do a Dexa every 6 months.

Third, if you are 62, you probably have private medical insurance. I've heard that women on Medicare have to fight harder to get a bone builder drug approved. My Tymlos is free because the company gives a coupon to those with private insurance, so no copay.

I wish, wish, wish I could go backward in time and tell myself to start Tymlos earlier. (sigh) Watch the video about drug proper drug sequencing (you need a bone builder like Tymlos or Forteo first- do not start with bisphosphonates). Do your research and choose a drug and start it, do the exercises and supplements. Your future self will thank you....

@indenial I am 65 and just diagnosed with osteoporosis. My L4 is also -4, left hip -3.6. I am absolutely with you on concerns with these medications. Your post yielded very helpful responses. I am so grateful for Mayo Connect! I have to agree with others that no medication with these scores is riskier than the side effects. I am doing my research and taking my time to find the treatment that I think best fits my circumstances. Then when I sit down with my doctor again I will be better informed and we can hopefully agree on a treatment plan. It's definitely not an easy decision! Please take your time and continue to research and read others experiences. I wish you the best.

If you are really lucky, you won't fall and break a hip.

If you are less lucky, you'll break a hip and get a hip replacement. It's not a fun process.

If you are old enough and unlucky enough, you'll fracture a spine and be crippled. Or, you'll break a hip and die in a nursing home. That happens all the time. A broken hip for an elderly person is usually a death sentence.

Don't stick your head in the sand. -3.8 is a really bad score. Don't be scared of all the talk of side effects. Here's what I am doing. I took Tymlos for two years and made great gains. I don't even have osteoporosis anymore. I'm now taking Fosamax. The plan is to take it for a while (as yet undetermined), then take a "drug holiday." Then, we'll play it by ear. BYW, I agree that meds like Prolia and Reclast can be daunting. I'm much more comfortable with the path I've chosen.

P.S. Although it is helpful, all those things you are doing aren't going to make a big dent in a -3.8 score, not by a long shot. Calcium + vitamins + walking will not make a big difference, I promise you.

The only thing that has really stopped me from starting treatment is the rebound, after gains are lost within a few years. Have also read many reports about bones being even more brittle and more prone to fractures after gains are lost. These are the things that keep me up at night. That, and my T12 compression fracture from 10 months ago that isn’t healing properly because of my osteoporosis, of course.

@njx58 thank you for your input. I’m aware that all the things I’m doing won’t make much of a dent, but I’m trying to just maintain and do the best I can until I finally bring myself to make a decision or something more promising comes out. Reading reports of rapid bone loss is what has scared me away from committing to a medication. At one point, I thought Tymlos, followed by Reclast, was the best option. My endocrinologist hasn’t been much help. When I asked what he recommended, he gave me a paper with all the medication‘s and told me to research and pick one. Researching is what led me to where I’m at now. After reading that when the gains wear off and rapid bone loss takes place, bones are more brittle than before treatment was started. This is what scared me away

@mjb24 Thanks so much! I’ve suffered two fractures in the last few years and still can’t commit to a medication yet. I would love to hear from someone who has completed treatment and is several years out, as this is the timeframe that worries me the most. After the gains wear off. Good luck in your journey as well

@indenial, it is true that many of the osteoporosis medications make the bone more brittle.
The two medications that don't are Forteo (teriparatide) and Tymlos (abaloparatide).
They make the strongest most vascular bone by removing older fissured bone before replacing it with new bone. These two medications hasten the healing of fractures. In addition they increase the number of chondrocytes, rebuilding the structure of bone that has been lost to osteoporosis.
I haven't taken Tymlos, but am on Forteo and think it is the very best of all the medications. I've been lucky not to have any side effects. Some do have side effects, but you can stop taking the drug without penalty. There isn't any rebound for anyone.
A few years after stopping the medication you lose the bone mineral content gained, but some fracture risk prevention is seen seven years after stopping the drug.

Another advantage of Forteo is that it lessens the pain of vertebral fractures.

@indenial So sorry to hear you have experienced these fractures. Unfortunately, from what I've been reading it seems like the medications are pretty much life long with possibly some drug free holidays. I will be interested in following your thread to see what others have experienced.